Back pain is a widespread problem experienced by women during pregnancy. It can be present from the early stage of pregnancy or in the later stage. The prevalence varies with reports showing between 50% to 70% of pregnant women experiencing back pain. The pain in the lower back area can be localised or can spread upwards or downwards from the legs. Back pain can disrupt the daily routine or interfere with good night sleep.

Causes of low back pain during pregnancy

Change in posture: As the foetus grows, the inward lordotic curvature of the spine (lumbar area) increases. Due to this change in posture, the back muscle, adjacent joints, ligaments have to work more for compensation, and thus pain develops.

Weak abdominal muscles: Muscles of the back support our spine. Weak abdominal muscles put extra stress on our spine; thus, back muscles have to work more to hold the spine correctly. With the growing foetus, the abdominal muscles become weaker, putting extra strain on the muscles, joints and ligaments of the back.

Joint laxity: During pregnancy, relaxin hormone is released to soften the ligaments and loosening of the joint structure for the accumulation of the growing uterus. This ligament laxity is responsible for pain.

Stretching: Stretching of the abdominal muscles and hip muscles also cause pain in the lower back.

Centre of gravity: The centre of gravity gradually shifts forward when the foetus grows within the uterus, which can lead to falling. To prevent slipping, the spine and other parts of the body try to adjust. This change in body posture puts extra pressure on the back and other areas, thus leading to pain.

Poor posture: Poor posture, standing or sitting for a long time and lying down incorrectly may also develop pain.

Excess weight: Women with more weight are likely to develop back pain as the weight of the foetus also adds up, putting extra pressure on the spine.

Pregnant women can consider the following ways to control back pain

• Try practising good posture by keeping the body straight, holding the shoulder back and not locking the knees. The body should be relaxed.

• Always try to stand with both feet a little apart so that you can get a wide base of support.

• Avoid standing or sitting for long. Put a pillow on the lower back curvature of the spine while sitting, and while standing, put one foot on a low tool.

• Lie on your sides with a pillow between legs.

• Wear a supportive or a maternity belt.

• Avoid wearing high heels.

• Avoid forward bending. Always lift objects by squatting.

• Try doing physical activity like walking, freehand exercise, mild stretching and easy household activities.

• Warm compress or massage can be helpful.

• Sleep on a firm mattress.

If a pregnant woman experiences severe back pain that lasts more than two weeks, or if the back pain is associated with fever, vaginal bleeding and burning micturition, then it can be a sign of urinary tract infection or preterm labour. In these cases, you should not delay and consult with your doctor immediately.

The writer is a Consultant of Obstetrics and Gynaecology.